Health Alerts Archive

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Bulletin/Alert/Advisory

Dec. 22, 2016Public
Health
Advisory

2016-17 Influenza Season

In the United States, flu season typically occurs in the fall and winter, mainly from October to March -- though it most often peaks between December and February. The Centers for Disease Control and Prevention (CDC) publishes a weekly flu surveillance report from October to May, called “Flu View,” with multiple sources of flu-related data. The California Department of Public Health also summarizes flu activity weekly, and as of Dec 10, 2016, statewide activity is considered sporadic. Click here for updated California data.

Locally, flu activity increased around Thanksgiving, based on data from local sentinel providers. There have not yet been any reports of outbreaks or severe illness, which are reportable events. Read More

Local surveillance data indicates influenza activity is increasing. The California Department of Public Health recently released updated guidance on the prevention and control of influenza in long term care facilities. Facilities should take the opportunity now to review the updated guidance and make preparations for increased influenza activity. Read More

Coccidioidomycosis, also known as Valley Fever, results from inhalation of Coccidioides immitis and Coccidioides posadasii spores. Although Santa Cruz County does not have any locally-acquired cases and is not considered endemic, Monterey County is a Coccidioides
endemic area -- particularly the Salinas Valley and South County regions. In October 2016, an unusually high number of Coccidioidomycosis cases among Monterey County residents were reported by local medical providers. Some individuals were severely ill and required extensive medical care. At this time, Public Health Officials recommend medical providers. Read More

The Centers for Disease Control (CDC) has issued a Health Alert stating that epidemiologic and laboratory evidence in the U.S. and Europe point to an association between invasive Mycobacterium avium complex (including M. chimaera) infections and exposure to contaminated Stöckert (or Sorin) 3T heater-cooler devices, used in many open-chest surgeries in California and nationwide. M. chimaera is a species of nontuberculous mycobacterium (NTM) commonly found in soil and water. The infected patients had undergone open-heart surgery that used contaminated heater-cooler devices during extracorporeal circulation.

These infections are difficult to treat and delays in diagnosis further complicate patients’ clinical management. Therefore, it is imperative that patients and providers are informed about the risk of infection associated with use of the 3T device and the need for appropriate diagnostic evaluation to facilitate timely diagnosis and treatment. Read More

Increase in Reports of Suspected Acute Flaccid Myelitis (AFM) Cases—2016Request for continued vigilance for case recognition and reporting

Surveillance for AFM has been conducted in California since 2012 and nationally since 2015. CDC received an increased number of reports of suspected AFM from May through July 2016; this increase is notable when compared to the same period in 2015. Clinicians are encouraged to maintain vigilance for cases of AFM among all age groups and to report cases of AFM to the patient’s local health jurisdiction. Reporting of cases will help the California Department of Health (CDPH) and CDC monitor the occurrence of AFM and better understand factors possibly associated with this illness. Read More

Due to the Loma Fire, Santa Cruz County Public Health Division continues to track air quality in Santa Cruz County in conjunction with the Monterey Bay Air Resources District (http://mbard.org/air-quality/). Air quality may change frequently due to fire behavior and weather patterns.

Health Officials recommend that residents actively assess their risk for exposure to unhealthy air quality from wildfire smoke and take appropriate actions. Symptoms that may develop from wildfire smoke include irritation of the lungs and eyes, coughing, scratchy throat and irritated sinuses. If you develop repeated coughing, chest tightness or pain, wheezing, difficulty breathing or nausea, call your medical
provider immediately. Read More

Influenza infection accounts for up to 49,000 excess deaths in the US each year and approximately 200,000 hospitalizations. Health Care Workers (HCWs) are both at risk for influenza and can transmit the virus to their vulnerable patients. Influenza vaccination of HCWs protects medically fragile patients and reduces employee absenteeism during influenza season.

State law requires that acute care hospitals and certain employers offer influenza vaccinations to employees or have the employee sign a declination statement if they choose not to be vaccinated. While compliance to these existing laws is high, actual HCW vaccination rates are not and may be below that which will blunt the spread of infection in a health care setting. Mandatory vaccination with masking policies have been shown to increase HCW vaccination rates to above 90%.

My goal is to increase the rate of influenza vaccination of HCWs, reduce employee absenteeism and protect Santa Cruz County residents from influenza infection. I believe you share these goals. Therefore, I am issuing the following Health Officer Order. Read More

2016

Zika Virus Information
Zika is an infectious disease caused by the Zika virus, which is transmitted to people by the bite of Aedes mosquitos and then transmitted sexually from infected individuals to sexual partners. Most infected people have no symptoms. If symptoms develop, the most common are fever, rash, joint pain, and/or conjunctivitis. Symptoms usually begin within 2 weeks after a person is infected, and last several days to one week. The illness is usually mild; severe disease requiring hospitalization is uncommon. On April 13, 2016 The U. S. Centers for Disease Control and Prevention (CDC) acknowledged that “A causal relationship exists between prenatal Zika Virus infection and microcephaly and other serious brain anomalies.” There is no specific treatment for Zika virus disease. To date there has been no local transmission of Zika Virus and no known transmission by mosquitos in California. Read More

This is an evolving situation and guidance may be modified when more information is available.

Outbreak of Invasive Meningococcal Disease involving Men who have Sex with Men in Southern California: Recommendations for Providers
Since March 2016, there have been 24 confirmed cases of serogroup C invasive meningococcal disease (IMD) -- including 2 deaths, among residents of Los Angeles and Orange Counties and the City of Long Beach. Of the 24 cases, 22 are men and of these, 19 identified as men who have sex with men (MSM). Persons with HIV infection are known to be at increased risk of invasive meningococcal disease, and two cases also had HIV infection. IMD results from infection with Neisseria meningitidis bacteria, which can cause meningitis, bacteremia and septicemia. Transmission is via contact with respiratory secretions or aerosols or someone carrying the bacteria in their nasopharynx; usually by close or sexual contact. Transmission occurs more easily in households and other crowded or congregate setting where there is close contact with many others. Read More

Cryptosporidiosis cases associated with Simpkins Swim Center
After receiving lab results of two individuals diagnosed with Cryptosporidiosis and conducting public health investigations, it is suspected the Simpkins Swim Center pools may have been contaminated. As a result, the pools have been closed and treated with an extremely high concentration of chlorine known to kill the organism because standard levels of chlorine used in swimming pools and hot tubs may not kill Cryptosporidium (also known as Crypto). Read More

Escherichia coli (E.coli) 0157 with Hemolytic Uremic Syndrome (HUS)
A cluster of E.coli 0157 with HUS potentially associated with a daycare in south Santa Cruz County has been reported to the Santa Cruz County Communicable Disease Unit. Two cases were both under the age of 5 years and are currently hospitalized for HUS. Onset of illness began at the end of June. There was delay in diagnosis. Symptoms of E.coli include diarrhea (often bloody), abdominal cramps and may be complicated by HUS as in these two cases. Read More

West Nile Virus (WNV) Update
The Davis Arbovirus Research and Training (DART) Lab at UC Davis notified Santa Cruz County Public Health Division on Friday, July 15, 2016 of this summer’s first find of a West Nile virus (WNV) positive sample of mosquitoes in Santa Cruz County. The sample of seven Culex pipiens, or Northern house mosquitoes, was collected by dry-ice baited trap hung by Mosquito and Vector Control (MVC) staff overnight on July 11 at Neary Lagoon in Santa Cruz and submitted on July 12, 2016. WNV is primarily a bird virus that can affect humans and other animals and can be spread by the bite of summer mosquitoes. In humans, symptoms of infection range from no symptoms to fever and flu-like illness to serious illness affecting the central nervous system in less than 1% of cases. Read More

Wound Botulism Associated with Drug Injection
Since May 29, 2016, two highly suspect cases of wound botulism associated with heroin injection (potentially black tar heroin) have been reported in Santa Cruz County. The two hospitalized cases are apparently unknown to each other and presented with wound infections and a recent history of injecting heroin. Symptoms included diplopia, bilateral ptosis, extraocular palsy, slurred speech, dysphagia, and generalized weakness. The patients were treated with botulism antitoxin released by the California Department of Public Health (CDPH). The sources of the botulism remain unknown and additional cases may occur. Read More

Overdoses and deaths due to counterfeit drugs contaminated with fentanyl
California Department of Public Health (CDPH) recently issued a statewide Drug Overdose Health Alert in response to an increased number of overdoses and deaths reported by Sacramento County and anecdotal reports of similar overdoses in other counties.

Since late March, Sacramento County has reported 52 overdoses of illicitly obtained drugs, including 12 deaths. Contra Costa County reported 10 overdoses and Santa Clara County reported two overdose deaths. Many of these overdoses and deaths were the result of consumption of pills that strongly resembled the prescription opioid drug Norco (hydrocodone/acetaminophen) but actually contained an undetermined amount of fentanyl, a powerful synthetic opiate analgesic much more potent than morphine and heroin. Read More

On May 13, 2015, the CDC changed the Ebola classification for Liberia to a “country with former widespread transmission and current, established control measures” – if a patient has recently returned from Liberia, please call the Communicable Disease Unit during business hours at 831-454-4114 and after hours call 831-471-1170 and be sure to follow these steps:

Conduct a travel, Ebola exposure, and health history.

Isolate in a private room ONLY IF patient’s travel/health history indicates a significant risk of Ebola exposure.

Opioid Overdoses in Santa Cruz Caused by Counterfeit “Xanax” Pill Containing Fentanyl
The Sheriff’s Office received information that a counterfeit version of the prescription drug alprazolam is being sold on the street in Santa Cruz County. Alprazolam is a benzodiazepine with brand names that include Niravam and Xanax. This street alprazolam may be linked to two recent overdose deaths. Alprazolam is a medication used to treat anxiety disorders, panic disorders and anxiety caused by depression.

Shigella Investigation
Santa Cruz County Public Health Communicable Disease Unit is currently investigating suspect cases of Shigella that may be linked to the current Shigella outbreak in Santa Clara County. Since Saturday October 17th, over 40 individuals have become acutely ill with fever, abdominal pain, and diarrhea and have been reported to the Santa Clara County Public Health Department (SCCPHD); all of these individuals ate at Mariscos San Juan restaurant #3 (205 N. 4th Street in San Jose) on Friday or Saturday (October 16th or 17th). Most of the ill persons reported to SCCPHD have required hospital admission, of which 12 required admission to intensive care. It is suspected that these cases represent only a small proportion of the total cases. Thus far, at least 15 of the reported cases are laboratory confirmed with Shigella (shigellosis). An investigation of this Shigella outbreak is underway, and lab results from additional cases are expected to arrive daily.

As of Monday, October 26, 2015, at 5:00pm Santa Cruz County had 3 confirmed cases, 1 probable cases, and 2 secondary case of Shigella.

(A)Probable: A person reporting acute diarrheal illness after eating at Mariscos San Juan on either October 16 or 17, 2015

(C) Secondary case: A person with diarrheal illness or Shigella infection who did not eat at Mariscos San Juan but had exposure to a confirmed or probable case between 12‐72 hours prior to illness onset

State Public Health Officer Warns of Invasive Mosquitoes Detected in California
The California Department of Public Health (CDPH) issued a warning to Californians regarding the growing threat from invading, exotic mosquitoes: the Asian tiger mosquito (Aedes albopictus), and the Yellow fever mosquito (Aedes aegypti). In September 2015, Aedes aegypti was detected in San Bernardino and Riverside Counties, bringing the count to twelve California counties in which one or both Aedes species have been detected since 2013.

These invasive species have not yet been found in Santa Cruz County. Our County mosquito program has deployed detection traps, but first detections in other counties have been the result of reports from the public of daytime biting by aggressive black and white mosquitoes.

Pinto Lake AdvisoryRecent testing of various locations around Pinto Lake has indicated the presence of harmful levels of toxins produced by blue-green algae. These areas include include City and County parks. Warning signs have been posted.

People and pets should not have contact with or drink the water. Boating is also not recommended due to the risk of contacting the water. Toxins from blue-green algae are known to have caused several deaths in dogs in Humboldt, Alameda and Sacramento Counties. Toxins released by the type of blue-green algae found in Pinto Lake can cause respiratory problems, liver problems, skin rashes, and gastro-intestinal upsets in humans and can cause stumbling, foaming, tremors, and death in animals.

October is Sudden Infant Death Syndrome (SIDS) Awareness Month
In 1991 the American Academy of Pediatrics (AAP) recommended that infants be placed on their back to sleep, and since then, the number of SIDS deaths in the United States have dropped by more than half. However, SIDS remains the leading cause of death for infants one month to twelve months of age. In 2011, the AAP made additional recommendations for infant sleep safety that incorporated the Safe to Sleep campaign by the National Institute of Health (NIH). The flyers may be downloaded or free copies may be ordered in English and Spanish to share with parents and caregivers at http://www.nichd.nih.gov/SIDS.

Lower San Lorenzo River Lagoon Health Advisory
Recent testing of the lower San Lorenzo River Lagoon at the railroad trestle has indicated the presence of harmful levels of toxins produced by algae and blue-green algae in the water.

People and pets should not have contact with or drink the water. Toxins from blue-green algae are known to have caused several deaths in dogs in Humboldt and Alameda Counties. Toxins released by the type of blue-green algae found in the San Lorenzo River Lagoon can cause respiratory problems, liver problems, skin rashes, and gastro-intestinal upsets in humans and can cause stumbling, foaming, tremors, and death in animals.

Measles continues to circulate in much of the world outside of North and South America. With the start of the new academic year be alert for patients presenting with rash and fever who also may be returning to campus from international destinations. Remember to notify your County of Santa Cruz Communicable Disease Unit (CDU) immediately if you suspect measles.

SACRAMENTO - California Department of Public Health (CDPH) Director and State Health Officer Dr. Karen Smith today announced the department is investigating a case of human plague in California, and conducting an environmental evaluation in the Stanislaus National Forest, Yosemite National Park and the surrounding areas.

The department began investigating this incident after a child from Los Angeles County became ill and was hospitalized after visiting the Stanislaus National Forest and camping at Crane Flat Campground in Yosemite National Park in mid-July.No other members of the camping party reported symptoms and health officials are continuing to monitor the child’s family and treatment providers. The child is recovering. Read More...

July 17, 2015

Recent Meningitis Activity

A 10 year-old Santa Cruz County resident died of suspected viral encephalitis last week. The child presented with symptoms of and was diagnosed with meningitis.

To date, extensive laboratory testing has not identified any causal organisms. There has been community concern regarding this case however there are no Public Health actions required of providers at this time.

Elevated Bacteria Levels at Capitola Beach West of Jetty
The most recent water quality results for Capitola Beach west of the jetty, sampled on June 2, 2015, indicate bacteria levels above safe body contact standards. The beach has been posted with swimming advisory signs. Water testing will continue and warning signs will be maintained until bacteria levels fall below the safe body contact standard. No other Santa Cruz beaches are affected by this advisory.

Rabid Bat FoundA bat, brought into the Public Health Laboratory by the Santa Cruz County Animal Shelter, tested positive for rabies on April 9, 2015. There were no known human exposures to this bat. Two dogs were quarantined as they might have been exposed.

INFORMATION

Do not touch a dead or injured bat. Call Santa Cruz County Animal Shelter at 831-454-7303 and they will remove it safely.

Children should be instructed to avoid approaching any unfamiliar animal, especially a wild animal. If you find an animal in distress, call the Animal Shelter.

Pets are at risk for rabies. Be certain your dog, cat or any pet who spends time outdoors is up-to-date on their rabies vaccine. If you find your pet playing with an injured or ill-appearing wild animal, notify your veterinarian and Animal Control immediately. Animal Control can be reached at 831-454-7303.

End of Influenza Season
Based on local influenza activity reports, I am declaring an official end to the influenza season as of April 3, 2015. While you may continue to see cases of influenza, I am assigning a specific date to the end of flu season to aid health care facilities in determining when unvaccinated employees may stop using masks.

National Public Health Week Begins April 6th
Public Health Departments across the country will be participating in National Public Health Week events from April 6th through April 12th. This year’s theme is “The Healthiest Nation in One Generation”.

Santa Cruz County’s Public Health staff have put together a campaign to remind county residents of the impact that Public Health has on everyone and how Public Health has changed our lives and communities for the better. Look for six different
“Public Health Is . . . “ posters in restaurants, retail shops, and schools which are designed to get residents thinking and talking about all the ways Public Health influences our personal decisions which promote good health.

We are asking all providers to be alert for University of Oregon students who present for acute medical care.

Six cases of serogroup B meningococcal disease have been reported among University of Oregon students with onsets during January 13th to March 15th. The outbreak is considered ongoing. Most of the cases involved meningococcemia rather than meningitis, and many presented initially with nonspecific symptoms. Because many students will be home or traveling during Spring Break, March 20th to March 29th, it is essential that providers in California be aware of the situation.

Measles Cases in California & Santa Cruz
Seventy-three (73) cases of measles have been confirmed among California residents since late December 2014. Fifty (50) of these cases have been linked to Disneyland or Disney California Adventure Park. Cases have been reported in Alameda, Los Angeles, Orange, Riverside, San Bernardino, San Diego, Santa Clara, San Mateo, and Ventura Counties. There have been no confirmed cases of measles in Santa Cruz County in 2015. Due to the extent of this outbreak, it is possible we will see cases here.

Electronic Cigarettes: Summary of Public Health Risks and Recommendations for Health Care Professionals
This health advisory seeks to inform health care professionals of the public health risks posed by the marketing, sale and use of electronic cigarettes (e‐cigarettes) especially to children and young people. Electronic cigarettes (e‐cigarettes) are battery‐operated devices, often designed to resemble a cigarette, that deliver and emit a nicotine‐containing aerosol. E‐cigarettes are considered electronic nicotine delivery devices (ENDS) and have many names. They are frequently referred to as e‐cigs, e‐hookahs, hookah pens, vapes, vape pens, vape pipes, or mods. There are disposable and rechargeable e‐cigarettes as well as refillable “tank systems” that hold a larger volume of the e‐cigarette liquid (e‐liquid) and that heat the e‐liquid to higher temperatures.

Enterovirus Update for Medical Providers
The California Department of Public Health has confirmed 4 cases of EV-D68 cases in patients in San Diego (3) and Ventura (1) counties. These are the first confirmed cases in California in 2014 due to EV-D68. More cases are anticipated in the coming weeks.

Ebola Virus Disease (EVD) - Evolving Situation
The current Ebola outbreak is an evolving situation. While the risk of importation of Ebola into the United States is considered to be very low, the California Department of Public Health (CDPH) is working with local health departments to prepare in the event that a returning traveler from affected countries develops the illness.

Contact the Santa Cruz County Communicable Disease Unit (CDU) IMMEDIATELY at (831) 454-4114 if you suspect a patient has EVD. After hours, please call (831) 471-1170.

For Medical Providers:
On September 30, the Centers for Disease Control and Prevention (CDC) confirmed, through laboratory tests, the first case of Ebola to be diagnosed in the United States in a person who had traveled to Dallas, TX from Liberia.

2014 West Nile Virus Update
West Nile Virus (WNV) has been detected for the first time in 2014 in a dead bird found in the upper Rodeo Gulch Road area (Soquel hills).This was an acute infection of WNV which indicates that there are mosquitoes in the area that can transmit the infection.

Over 1,700 cases of pertussis have been reported to the California Department of Public Health (CDPH) in the first four months of 2014. This represents more than a 3-fold increase compared to the same time period in 2013. In Santa Cruz County, 12 cases of pertussis have been confirmed in the first quarter of 2014 compared to one case in the first quarter of 2013.
As of 5/30/14, we have had a total of 26 confirmed cases of pertussis. Statewide, teenagers appear to be the age group most affected by this illness.

As many residents know, this spring the mosquitoes are worse than ever! Because the Watsonville sloughs dried in the winter, the fish that prey on the mosquito larva died also, so the mosquitoes are breeding thickly. Also, the miles of small streams throughout Santa Cruz County have slowed to a trickle, forming small pools where mosquitoes are breeding. The County is experiencing rapidly warming and lengthening days, and the light spring rains were just enough to leave standing water in gutters and low places. Stagnant rainwater left in buckets, birdbaths, and tires is warmed by the sun and becomes a breeding ground for mosquitoes, hungry for blood. This time of year, mosquitoes breed anywhere and everywhere in water held by tarps, boat bilges, clogged drains, gutters and unmaintained swimming pools, spas, fountains and fish ponds.

The first case of MERS-CoV infection has been identified in a traveler from the United States. This new development was confirmed by the Centers for Disease Control and Prevention (CDC) on May 2, 2014. The patient is hospitalized in Indiana after having flown from Saudi Arabia to Chicago via London. Most people who get MERS-CoV develop severe acute respiratory illness, with symptoms of fever, cough and shortness of breath. There is clear evidence of person-to-person transmission, though the specifics of modes and routes of transmission are still being investigated by the World Health Organization (WHO) and the CDC. Neither organization has yet to issue travel warnings to any of the countries affected. We are asking physicians to increase their index of suspicion and to consider MERS-CoV infection in travelers from the Arabian Peninsula and neighboring countries.

The Centers for Disease Control and Prevention (CDC) have issued a new document, which consolidates the recommendations for Hib vaccine for both adults and children. Please go to http://www.cdc.gov/mmwr/PDF/rr/rr6301.pdf for complete guidance.

The California Department of Public Health (CDPH) is advising consumers not to eat commercially or recreationally caught anchovy or sardines, or the internal organs of commercially or recreationally caught crab taken from Monterey and Santa Cruz counties.

Dangerous levels of domoic acid have been detected in some of these species and could be present in other species. Anchovy and sardines are of concern because the toxin resides in their digestive tracks. These fish are not usually gutted before they are eaten. CDPH is working with commercial fishermen in the area to ensure that recently caught sardines, anchovies and crab were not distributed into the human food supply.

This health advisory is in addition to the April 4 warning not to eat recreationally harvested bivalve shellfish (such as mussels, clams or whole scallops) from Monterey or Santa Cruz counties due to dangerous levels of domoic acid in mussel samples.
That warning does not apply to commercially sold clams, mussels, scallops or oysters from approved sources. State law permits only state-certified commercial shellfish harvesters or dealers to sell these products. Shellfish sold by certified harvesters and dealers are subject to frequent mandatory testing to monitor for toxins.

CDPH continues to collect bivalve shellfish, fin fish and crab samples from the area to monitor the level of domoic acid in seafood. There have no reported illnesses associated with this event.

49 Measles Cases in the State of California in 2014
Look for Signs of this Highly Contagious Disease
Measles activity continues to be high in California this year. As of March 27, 2014, 49 confirmed measles cases with onset in 2014 had been reported to California Department of Public Health. In 2013, four measles cases had been reported by this date. Among the 2014 cases, 11 patients had traveled outside of North and South America with travel to the Philippines (n=8), India (n=2), or Vietnam (n=1). Of the patients without international travel, 30 had contact with known measles cases, 3 had contact with international travelers and 5 are under investigation to identify potential sources. Measles cases have occurred in both Northern and Southern California; however, the majority of cases are in Southern California (40/49). Several large contact investigations are ongoing.

Cases range in age from 5 months to 60 years. Of the 29 measles cases for whom vaccination records are available: 22 were unvaccinated (16 were intentionally unvaccinated, 3 were too young to be vaccinated, 3 were not vaccinated for unknown reasons), and seven had received appropriate vaccination. Immunization data collection is ongoing and vaccination status is preliminary. Transmission has occurred in the following settings: households, urgent care clinics, physician offices, hospitals, churches and schools.

There are 10 independent measles transmission chains. Four originated from imported cases (Philippines, n=4), two from cases who had contact with international travelers and four from cases with unknown source. A large measles outbreak is ongoing in the Philippines with over 15,000 cases in 2014, but measles is also circulating in many other countries outside of North and South America.

Based on local influenza activity reports HSA Health Officer Lisa Hernandez MD, MPH is declaring an official end to the influenza season as of March 31, 2014. While you may continue to see cases of influenza, Dr Hernandez is assigning a specific date to the end of flu season to aid health care facilities in determining when unvaccinated employees may stop using masks.

From the current influenza season onward, the following order will be ongoing and will apply to each influenza season: At the start of each influenza season, through notification by the Health Officer, it will be mandated, that every health care facility and Emergency Medical Service provider in Santa Cruz County implement a program requiring that HCWs receive an annual influenza vaccine or, if they decline, wear a mask during the entire flu season while working in patient care areas.

The California Department of Public Health (CDPH) has received several requests for testing of viral agents in cases of unexplained acute flaccid paralysis. Many of these cases are described as “polio-like” syndromes. Several features of these cases indicate an infectious etiology. Thus far, testing has not revealed a single etiology. Testing has been hampered by incomplete specimens, samples taken late after onset of symptoms, and serum draws after IV immunoglobulin has been administered.

Locally, the Public Health Department has not received any reports of cases within our county. However, we are supplying the case definition and lab submittal procedures for local providers in the event that we have a local case.

In the last two months, there has been increased measles activity in our region. Our Communicable Disease Unit (CD) responded to one measles case at the end of December 2013. This one case generated eighty-eight (88) contact investigations by our CD staff and one hundred eleven (111) contact investigations for the California Department of Public Health (CDPH).

We are currently monitoring eight (8) contacts to two (2) cases of measles which originated elsewhere.

The first confirmed death due to influenza infection has occurred in Santa Cruz County in a male under the age of 50. Two suspect influenza deaths, in two males under the age of 50, have not yet been confirmed by the California Department of Public Health (CDPH). The Public Health Department has received official reports of five patients under the age of 65 admitted to the ICU with confirmed influenza. One of these five is the first confirmed death due to influenza. There are five additional suspect influenza cases in ICU under investigation.

INFORMATION

CDPH has reported seven confirmed influenza deaths statewide in persons under the age of 65. Twenty-eight more deaths are under investigation. Influenza deaths in persons over the age of 65 are not reportable in California.

The H1N1 strain appears to be the predominant strain so far this flu season and is contained in this year’s flu vaccine.

There is no shortage of vaccine and it is not too late to get vaccinated.

RECOMMENDATIONS

Get vaccinated.

If you do get sick, limit contact with others.

Cover your nose and mouth when coughing or sneezing, wash hands thoroughly with soap and water, or use an alcohol-based rub and avoid touching your eyes, nose and mouth.

Those at high risk (the elderly, pregnant women, infants or those with other health conditions) who show flu symptoms should contact their physician immediately in order to get the most effective treatment. Symptoms include the sudden onset of fever, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches and fatigue.

Middle East Respiratory Syndrome (MERS-CoV)
A novel coronavirus, known as Middle East Respiratory Syndrome (MERS-CoV) has caused severe illness and death in several countries. This coronavirus was identified in Saudi Arabia in 2012. As of today, 64 cases have been laboratory-confirmed, with 38 deaths. Most people who get MERS-CoV develop severe acute respiratory illness, with symptoms of fever, cough and shortness of breath. There is clear evidence of person-to-person transmission, though the specifics of modes and routes of transmission are still being investigated by the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC). Neither organization has yet to issue travel warnings to any of the countries affected. No cases have been reported in the U.S. as yet.

Santa Cruz County received the second report this year of a hospitalized person who became seriously ill after eating mushrooms collected in the La Selva Beach area.

Both illnesses were probably due to the mushroom Amanita phalloides.

RECOMMENDATIONS

Wild mushrooms should not be eaten unless they have been determined edible by a recognized mushroom expert.

Individuals who develop any of these symptoms--abdominal pain, cramping, vomiting, and/or diarrhea after eating wild mushrooms should immediately contact the California Poison Control System at 1-800-8-POISON (1-800-876-4766) or 1-800-222-1222 and seek immediate medical attention.

INFORMATION

In past years, multiple hospitalizations, gastrointestinal illnesses and even deaths, have been caused by the consumption of wild mushrooms.

The deaths have been linked to the Amanita ocreata mushroom, also known as the “destroying angel” and the Amanita phalloides mushroom, commonly called the “death cap” mushroom. · Poisonous mushrooms are found throughout Santa Cruz County. The most common are:

In recognition of September's designation as National Preparedness Month, the Santa Cruz County Department of Public Health has just completed a comprehensive guide to emergency preparedness intended to help the residents of Santa Cruz County prepare for, respond to, and recover from the disasters that affect our region.